Conversion disorder

Conversion disorder

What is conversion disorder?

Conversion disorder is a condition in which a person has physical symptoms, but with no physical cause. People with conversion disorder may lose their sight or hearing, become paralysed (unable to move), or display a number of other symptoms that involve the nervous system.

Conversion disorder is not common. It is estimated to occur in 2-5 of every 100,000 people. About 5-15% of people referred to neurology clinics are diagnosed with conversion disorder[1][2].

People with conversion disorder are not 'faking' - their symptoms are genuine, and they experience the same degree of disability as any other person with a disability. If a person is consciously faking illness, this is not conversion disorder but either factitious disorder (Münchausen syndrome), where a person pretends to have an illness for the sake of being considered ill, or malingering (where a person fakes illness for personal gain).[1]

Nervous system

The extensive network of cells and structures that is responsible for activating and coordinating the body's functions, sensory input and cognition.

Causes

Conversion disorder was known as 'hysteria' until 1968, and many explanations had been offered over the ages for its appearance. It is still not understood what causes this disorder; it may be the result of psychological or neurological factors, or a combination of the two.

The symptoms are often triggered by a stressful event - it may be that conversion disorder is a way for the brain to cope with stress by 'channelling' the emotional stress into physical symptoms[2].

Methods for diagnosis

Since the causes are not known and have much to do with the person's mental state, diagnosis of conversion disorder is not easy and not always accurate. Also, conversion disorder can occur along with neurological conditions, making diagnosis a difficult task.

The doctor will first try to find a physical explanation for the symptoms and will perform the appropriate examinations and tests. If no good alternative explanation is found and the person exhibits some of the risk factors listed above, the doctor may suspect conversion disorder.

A further complication of diagnosis is that in conversion disorder, the more the doctor investigates, the longer the patient's symptoms may continue[2].

Recent brain imaging studies suggest that in conversion disorder, the limbic system (the area of the brain responsible for emotion, among other things) influences or overrides the motor and sensory areas of the brain[2][3]. These are, however, only preliminary results.

Types of treatment

Treatment of conversion disorder is through psychotherapy (cognitive behaviour therapy), often in combination with physiotherapy and stress management techniques. Explaining the diagnosis to the person and reassuring them can also help. For people who also have another mental health condition, treating this disorder can also help relieve the symptoms of conversion disorder.

Trust is important. Placebo treatments, and other 'non-treatments' designed to mislead the person into thinking they are receiving treatment, are not recommended. They may impair trust between doctor and patient and sabotage future treatment efforts[4]. That said, some researchers argue that there is a place for such measures in treatment[5].

Transcranial magnetic stimulation, which uses a focused magnetic field to activate specific areas of the brain, is a suggested technique for treating conversion disorder. Trials show promise, but the therapy is still not in general use[2].

Psychotherapy can help with the management of conversion disorder.

Cognitive behaviour therapy

A psychological or 'talking' therapy that focuses on changing unhelpful thoughts and behaviours that are causing a person distress.

Psychotherapy

A therapeutic treatment, also known as talking therapy, used to treat different types of mental health issues ranging from shyness or depression to anxiety attacks.

Placebo

A medication or procedure that has no known physiological effect, but may produce a positive response if a person believes there to be a benefit.

Prognosis

For some, an episode of conversion disorder is temporary and can last for any length of time, from minutes to days or weeks. Episodes can recur; 20-25% of people who have had an episode of conversion disorder will experience another one within a year[2][4].

For others, an episode of conversion disorder is an ongoing affliction that can last many years. This is more common in people who suffer from other mental disorders[2][4].

Always ask your doctor or healthcare provider any questions you may have regarding a medical condition. In case of emergency, call your doctor or dial 000 (Australia) or 911 (United States of America) immediately.

Disclaimer

Welcome to Health&. We aim to help keep you healthy and well.

We provide helpful information and guidance to manage your health. The information is personalised to allow you to make better decisions about your health. We use the latest medical guidelines and provide information that has been reviewed by doctors at Health&. It is important to note that we only provide information - we do not provide medical diagnosis, treatment or advice. The health information provided should not be a substitute for professional medical care. Before acting on the information, please consult your doctor to make sure it is right for you. In the event of a medical emergency, immediately call your doctor or emergency services - dial 000 (in Australia) or 911 (in the United States of America).

At Health&, you can securely store your health records. We respect the need for privacy and security of personal information. We are bound by legal requirements for privacy in Australia. Health& is also a registered Healthcare Provider Organisation (just like your doctor), so we will not share your personal information with anyone. We apply the highest levels of security for the storage, management and access of your personal information, using industry standards for encryption. To further safeguard your information, we recommend that you use a strong password and take care to protect it.

Health& is the first consumer-led population health study in Australia. We collect anonymous health data to support medical research and population health initiatives. The information contributes to major improvements in the health of communities. Your participation helps others to also benefit.